Individual
ELLEN LYMAN THOMASON DERRICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
3216 NE 45TH PL STE 207, SEATTLE, WA 98105-4028
(206) 596-3976
(206) 486-9013
Mailing address
6541 50TH AVE NE, SEATTLE, WA 98115
(206) 818-6905
Taxonomy
Speciality
Code
Description
License number
State
2086S0129X
Vascular Surgery Physician
Primary
MD00045873
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1659480630
—
WA
Enumeration date
08/30/2006
Last updated
07/21/2022
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